Michelle Marenfeld takes her dog, Drax, for a walk around her Tucson neighborhood.

 Mamta Popat, Arizona Daily Star

Arizona’s COVID-19 case counts are still plummeting, but this promising shift hasn’t relieved the state’s hospitals.

Families and patients are instead finding they have to advocate more forcefully for those who need care as theΒ  state’s emergency rooms in particular continue to be swamped.Β 

This is not just due to COVID-19 but also to people coming in who were reluctant to seek care earlier in the pandemic, health officials are reporting.

COVID-19 patients occupied only 21% of inpatient beds Thursday, state Health Department data shows, down from 41% in late January, but hospital beds overall still remain close to full, with non-COVID patients taking up nearly all the rest. Only 6% of Arizona’s inpatient beds were available as of Thursday.

The data also shows emergency room usage continues to be consistently higher over the last two months than during the entire pandemic, jumping from being between 25-40% full in March and April 2020 to 65-75% full over the last two months.

β€œOur emergency rooms have been so busy and so overwhelmed that they have had to come up with creative ways to get people the care they need,” said Dr. Monica Vandivort, a geriatrician who works in Cochise and Pima counties, providing both in-home care and telehealth visits over the phone or computer.Β 

β€œPeople are presenting with advanced cases of just about everything,” said Vandivort, who is also an associate professor at the University of Arizona's College of Medicine.

Tucson Medical Center, which has one of the busiest emergency rooms in the state, reported that non-COVID patients are coming in sicker, requiring more care, and are staying for longer than the hospital typically sees.

Many staff members at TMC have also been absent due to illness and positive COVID-19 tests, β€œwith about 15% of our nurses calling out on any given shift.” Nurses with Tucson’s Carondelet, St. Mary’s and St. Joseph’s hospitals, picketed recently, calling their working conditions unsafe because staffing levels are so low.

β€œTMC is dedicated to all of the patients who come to us for care,” hospital spokeswoman Angela Pittenger said in an email. β€œWe do this by carefully allocating staff to the area of most need, bringing in travel nurses and other critical staff, and offering incentives to retain core staff.”

The care that’s provided normally is much different β€œwhen the hospital is not under the severe constraints we are currently facing.”

Several families shared stories with the Arizona Daily Star about their experiences with care and hospitals during these last weeks and months, including ways they tried to advocate for themselves and their loved ones. There’s been frustration, heartbreak, and also gratitude for the health workers who continue to provide care under very taxing conditions.

β€˜Very frustrating’

Roger and Neli Sprunt got sick with COVID-19 in late January but they weren’t worried until their 30-year-old son started showing symptoms, too.

Mathew Sprunt had asthma – and struggled with pneumonia when he was younger – so his lungs are especially vulnerable to respiratory viruses, his parents said.

Days before Mathew was admitted to Banner-University Medical Center South, the Sprunts had contacted the provider, desperate to get him antibody treatment, but they were told Mathew, who also has Down syndrome, did not qualify.

Banner spokeswoman Rebecca Ruiz Hudman said she could not comment on their specific case, but said patients have to reach certain risk factors to be considered for the treatment.

While his parents got better, Mathew’s fevers got worse and his blood-oxygen level became dangerously low. That’s when he was taken to Banner and started on oxygen.

It was hard for Mathew to have tubes in his nose, his parents said, and they were grateful one of them could be in the room to help Mathew and advocate for him. Their three other children came in from out of town to cover shifts, as Mathew’s oxygen needs increased.

β€œThe nurses were very busy and could not provide the close attention Mathew received from family members,” Roger Sprunt said, adding that he thinks the family being there was β€œcrucial for Mathew’s quick recovery.” He said they were also happy to help relieve the workload of the nurses.

As the illness continued, Roger Sprunt became anxious about his son needing to eventually be intubated and asked again about antibody treatment. He said he was told that it was too late for that, now that Mathew was hospitalized and receiving oxygen.

β€œIt was very frustrating,” he said.

Eventually, Mathew was receiving 40 liters of oxygen per minute and that high flow through the tubes really bothered him. That’s when his parents started trying to help with the nasal congestion, hoping Mucinex and nasal spray would help. It did, and they were able to switch from nose tubes to an oxygen mask.

Mathew is home again. He was released from the hospital after nine days, a much shorter stay than expected.

β€˜Knew what it was I should be looking for’

Michelle Marenfeld was playing a board game with her husband and son when the nausea and discomfort started.

She initially took an antacid that evening, almost two weeks back, thinking it might be indigestion, but then the pain started. Marenfeld’s husband immediately drove her to TMC’s emergency room.

Heart problems run on both sides of Marenfeld’s family and the 44-year-old mother of two, who developed high blood pressure in her 20s, knows what to watch for.

The heart attack symptoms were obvious to her when she arrived around 9:45 p.m., breathless and bent over with pain, to find the ER standing room only.

She was immediately triaged, or assessed, and an electrocardiogram (EKG) test was given to see how the electrical signals in her heart were doing. Her blood pressure was high. Then she returned to wait in the lobby.

β€œThere wasn’t even a chair for me to sit in so I kind of crouched down,” she said. β€œThen a really nice man gave up his chair and let me sit.”

During this time, she said, the pain in her chest was severe. Around 11, she said, a technician told her the EKG test came back normal. At 11:30, she had blood drawn and briefly saw a physician.

β€œThe first thing she asked me? β€˜How many days have you been in pain?’ ” Marenfeld recalled. β€œI said, β€˜Days?’ ”

Back to the waiting room again. The pain had now dulled a bit and moved to her jaw and upper back, she said, and the nausea was coming and going. Marenfeld took notes about how she was feeling so she could later share what she had been experiencing. She said she was afraid the fear and fatigue would cause her to forget a critical detail.

At 4:45 a.m., she asked how many people were still ahead of her – there were two – and said she was told they didn’t know how much longer it would be. She was freezing, she said, and desperately wanted to sleep for just a couple of hours. She told the ER attendant she was going home and would return.

She slept for a few hours and woke up around 9 a.m., still in considerable discomfort. There were messages on her MyChart patient app that had come in a couple of hours earlier, at 7 a.m., showing her blood test results were in and had been completed since 12:34 a.m.

She scanned for the word she knew could mean trouble: troponin.

Troponin is a protein that’s found in the muscles of the heart, and its presence in the blood was a sign Marenfeld knew to look for, a warning that her heart could be headed toward serious trouble, or already there. There was also a new comment logged on her EKG that morning that she didn’t notice until later: β€œconsider left atrial enlargement.”

β€œI was in the ER for four hours and was not called or seen,” she said. β€œLuckily, I knew what it was I should be looking for.”

When her husband brought her back that morning, she showed them her test results. They took her in immediately.

From there, she was put in a bed, started on an IV with blood thinners, given nitroglycerin and, she said, had a wonderful nurse assigned to her.

By this time, her troponin level had risen dangerously high, but she was finally getting the care she needed β€” and is grateful to the nurses and doctors who helped her.

β€˜Not just two old people’

William Hewes knows the heartbreak of fighting for a loved one but not getting help in time.

His wife died in November after she developed a blockage in her bile duct and there were no hospital transfers available from Sierra Vista’s Canyon Vista Medical Center to Tucson or Phoenix for more than a week.

β€œWithout a doubt, that’s what caused her to go downhill,” he said of the prolonged wait in early September. β€œShe had all the things you get from long-term hospitalization. She went from (being) a person who could take care of herself to a person who needed to be in a wheelchair.”

Hewes said the transfer was supposed to be to St. Joseph’s Hospital in Tucson, but that never materialized. Instead, a nurse started making calls, he said. After several hours, she found a spot in a Phoenix hospital.

Hewes was shocked there wasn’t a better system for finding available beds during a pandemic, and angered unvaccinated COVID-19 patients were prioritized through the state’s COVID-19 transfer line.

William and Maureen Hewes on their wedding day, Sept. 12, 1964, in a chapel at the Royal Air Force Base in Bentwaters, England. The couple met a year earlier at the officers' club in London.

By the time Maureen β€œMo” Hewes was moved to Phoenix, her husband said her health had deteriorated considerably. The day before her surgery, Sept. 12, was their 57th wedding anniversary.

Hewes said he brought in a wedding photo of them standing in a chapel at the Royal Air Force Base in Bentwaters, England, where he had been stationed in 1964. They’d met a year earlier, he said, at the officers’ club in London.

Along with that, he also brought in a more recent photo of them, in their early 80s now but still enjoying life very much. Hewes, a retired attorney, said they loved to travel in their RV and belonged to the Escapees RV Club.

β€œI think by doing that, by showing them the picture, I could show them we weren’t just two old people who probably should die anyway,” he said. β€œWe had a great life.”

During the first surgery, it was determined that they also needed to take out her gallbladder, a procedure that took place a few days later.

Finally, after about three weeks, Hewes and his wife returned to Sierra Vista to start rehabilitation, but Hewes said Mo had lost her vigor. She began to have falls.

After she finally returned to her home from the rehab center, he said, her breathing became labored and she grew extremely weak. She was taken to Banner-University Medical Center in Tucson this time, and diagnosed with sepsis and a severe bacterial infection in her digestive tract.

She died Nov. 10.

β€˜Pursuing every avenue’

Anne Audrain isn’t sure where her husband Nate Cooper got exposed to the COVID-19 virus, but she thinks it might have been the mid-January day he’d gone out to run some errands. Within a few days, she said, the coughing started.

The couple live in Cochise County and, luckily, not very far from Dr. Vandivort, a friend of Audrain’s from the community.

As Cooper’s coughing got worse, Vandivort recommended a visit to the emergency room at Bisbee’s Copper Queen Community Hospital. She wanted Cooper to get a COVID-19 test and to see about antibody treatment. But Audrain soon learned the hospital in Bisbee did not have antibodies or even tests available at that time.

So, instead, she drove to Vandivort’s house and picked up a test. No surprise, he was positive.

What Audrain knows after nearly 30 years with Cooper is that he’s a very determined person, so she was not surprised when he told her he wanted to fight the infection at home. There would be no hospital stays, she said.

β€œHe wasn’t going no matter what I said,” she said. β€œI was certainly pursuing every avenue.”

From there, they started doing telehealth meetings, using a pulse oximeter and a blood pressure device they had at home.

With the support of his wife and telehealth, Cooper was monitored as he rested at home.

He’s now completely recovered, Audrain said.

He will turn 94 next month.

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Contact reporter Patty Machelor at 806-7754 or